Provider Demographics
NPI:1811065840
Name:CALVO-JONES, LOURDES M (DDS)
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:M
Last Name:CALVO-JONES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 S SEACREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7935
Mailing Address - Country:US
Mailing Address - Phone:561-732-2711
Mailing Address - Fax:561-732-0287
Practice Address - Street 1:2860 S SEACREST BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7935
Practice Address - Country:US
Practice Address - Phone:561-732-2711
Practice Address - Fax:561-732-0287
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX227921223G0001X
FLDN17213122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice